A survey of current perianesthesia nursing practice for pain and comfort management

Widespread dissemination of information and high-profile press coverage about pain and comfort management has resulted in heightened awareness among health care professionals and the public of the need for improvements in the way pain and comfort are managed. Despite significant advances in treatment options for pain relief and comfort, studies show that both phenomena continue to be poorly managed and undertreated. Providing pain relief and comfort to patients are important fundamental components of good nursing care; however, no studies have been performed to evaluate these responsibilities in perianesthesia nursing practice. Therefore, a descriptive survey was undertaken to assess the current practices for pain and comfort management among perianesthesia nurses. A convenience sample of 220 perianesthesia nurses working in preoperative and postoperative settings in rural and urban hospitals, outpatient centers, and freestanding facilities completed a questionnaire survey. The survey asked 10 questions that addressed various aspects of pain and comfort care, including assessment in different settings, discharge criteria, and obstacles in the management of pain and comfort. Findings showed that perianesthesia nurses assessed pain at a frequency of 58% and comfort at a frequency of 56% on admission. Preoperative assessment of patients' desired level of pain relief and comfort occurred at frequencies of 21% and 20%, respectively. Pain was assessed most often with self-report pain ratings and ordinal descriptions such as "no pain" to "severe pain." A moderate pain level was used most often as a discharge criterion. Inappropriate and inadequate physicians' orders were cited as two of the most common obstacles to managing pain and comfort. Findings of this study can be used to increase awareness of the need to evaluate and improve pain and comfort management education and practices in the perianesthesia settings. ASPAN will also use the results as baseline data as it establishes a strategic plan to address the educational needs of its members.